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Membership Form
南 洋 廖 氏 公 会
新加坡芽笼廿九巷门牌二十四号
NANYANG LEOW SIH ASSOCIATION
24 LORONG 29 GEYLANG #06-00
SINGAPORE 388073
TEL: 6743 3889
永久会员入会申请书
APPLICATION FOR INDIVIDUAL PERMANENT MEMBERSHIP
用户照片
User photo
英文姓名 Name (BLOCK letters):
中文姓名 Name (Chinese Characters):
头像 Profile Picture:
出生日期 Date of Birth:
年龄 Age:
性别 Gender :
男 M
女 F
办事处电话 Office Tel:
住家电话 Home Tel:
手提电话 Mobile No.
电邮 Email:
住家地址 Home Address:
居民证号码(请复印) Copy I/C No.
附上I/C图片 Attach I/C Picture:
籍贯 Dialect:
职业 Occupation:
教育 Education Level:
小学 Primary SCH
大学Tertiary
中学 Secondary School
学院 College
其他 Other
婚姻 Marital Status:
未婚 Single
已婚 Married
离婚 Divorced
同意规章制度 Agree with rule and regulation:
           签署此会员申请表,即表示您同意交会会收集、使用和披露您在本申请表中提供的个人资料,或(如适用)我们组织因您的会员资格而获得的个人资料,用于以下目的 根据 2012 年《个人数据保护法》和我们的数据保护政策:
(a) 处理此会员申请;
(b) 管理我们组织的会员资格。
                By signing this membership application form, you agree that Leow Shi Association may collect, use and disclose your personal data, as provided in this application form, or (if applicable) obtained by our organisation as a result of your membership, for the following purposes in accordance with the Personal Data Protection Act 2012 and our data protection policy:
(a) the processing of this membership application;
(b) the administration of the membership with our organisation.
申请人签名 Signature of Applicant:
介绍人/姓名签名 Signature of Introducer:
申请日期 Date of Application:
Submit